2021 Articles

Working with economically vulnerable women engaged in sex work: Collaborating with community stakeholders in Southern Uganda

Nabunya, Proscovia; Kiyingi, Joshua; Witte, Susan S.; Sensoy Bahar, Ozge; Mayo-Wilson, Larissa J.; Tozan, Yesim; Nabayinda, Josephine; Mwebembezi, Abel; Tumwesige, Wilberforce; Mukasa, Barbara; Namirembe, Rashida; Kagaayi, Joseph; Nakigudde, Janet; McKay, Mary M.; Ssewamala, Fred M.

Economically vulnerable women engaged in sex work (WESW) comprise one of the key populations with higher prevalence of HIV globally. In Uganda, HIV prevalence among WESW is estimated at 37% and accounts for 18% of all new infections in the country. This paper describes the strategies by which we have engaged community stakeholders in a randomised clinical trial aimed at evaluating the efficacy of adding economic empowerment components to traditional HIV risk reduction to reduce the incidence of STIs and HIV among WESW in Uganda. We demonstrate that stakeholder engagement, including the engagement of WESW themselves, plays a critical role in the adaptation, implementation, uptake, and potential sustainability of evidence-based interventions. To our knowledge, this is the first study to utilise stakeholder engagement involving WESW in Uganda. Researchers working with hard-to-reach populations, such as WESW, are encouraged to invest time and resources to engage key stakeholders through a full range of collaborative activities; and ensure that research is culturally appropriate and meets the needs of all stakeholders involved.